Question: Who treats autoimmune encephalitis (AE)?
The traditional answer: neurologists.
The jaded answer: no one does.
The real answer: a haphazard smattering of medical professionals who balance their knowledge of medical literature with sound clinical judgement and the needs of the patient.
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One day you’re at 60% capacity, feeling happy about the progress you’ve made towards recovery. That’s a far cry from the 5% you were in at the hospital when you were admitted for an acute attack.
But the next day, you’re back at 30%.
One day you’re in shock, having met a new doctor who not only acknowledged your deteriorating health but offered you the option of escalating treatment.
But the next day…
While being diagnosed with autoimmune encephalitis (AE) in the first place is scary, failing treatments that normally give people their lives back is despairing. Recognition of the failure is slow. You’re told to hang tight and be patient for the immune system to adjust; but as months pass by without sustained improvements, the feeling that something is wrong begins to take hold.
I’m walking down the street of a major American metropolis, bagel in hand, rushing to find a park bench so I can log in to Zoom. I look down at my feet, pause, and whip out my phone.
Perfect. This will do. *shutter click*
Leave it to a patch of dingy city sidewalk to embody my feelings of living with an inflamed brain.
Autoimmune encephalitis (AE) is a nightmare.
Internists don’t want to touch it. Psychiatrists look on with sympathy. And most neurologists would rather not acknowledge it at all, unless scores of paraclinical investigations are screaming in their face.
So you might begin to imagine how dejecting it feels to be the one actually living with this illness.
Two years ago this month, I was hospitalized for the first time. I was diagnosed with seronegative autoimmune encephalitis (AE). And I started 5 months of immunotherapy, roughly 5 years after my illness first began.
By November 2019, I thought the battle was won: I seemingly had all the answers to solve my medical mystery, which had been open since 2014. It was clear by that point that standard AE treatments had worked wonders to bring me back to my original baseline of good health and cognitive functioning. Sure, I knew relapsing was a possibility; but were that to happen, I figured that healing again would be as simple as resuming Rituxan.